Intravascular Ultrasound Findings That Are Predictive of No Reflow After Percutaneous Coronary Intervention for Saphenous Vein Graft Disease
- Authors
- Hong, Young Joon; Jeong, Myung Ho; Ahn, Youngkeun; Kang, Jung Chaee; Mintz, Gary S.; Kim, Sang Wook; Lee, Sung Yun; Kim, Seok Yeon; Pichard, Augusto D.; Satler, Lowell F.; Waksman, Ron; Weissman, Neil J.
- Issue Date
- Jun-2012
- Publisher
- EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
- Citation
- AMERICAN JOURNAL OF CARDIOLOGY, v.109, no.11, pp 1576 - 1581
- Pages
- 6
- Journal Title
- AMERICAN JOURNAL OF CARDIOLOGY
- Volume
- 109
- Number
- 11
- Start Page
- 1576
- End Page
- 1581
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/20250
- DOI
- 10.1016/j.amjcard.2012.01.383
- ISSN
- 0002-9149
1879-1913
- Abstract
- The aim of this study was to investigate the relation between intravascular ultrasound (IVUS) findings and the no-reflow phenomenon and long-term outcome after percutaneous coronary intervention (PCI) of saphenous vein graft (SVG) lesions. No reflow was defined as Thrombolysis In Myocardial Infarction grade 0, 1, or 2 flow after PCI. Of 311 patients who underwent IVUS before and after stenting, no reflow was observed in 39 patients (13%). Degenerated SVG (62% vs 36%, p = 0.002), IVUS-detected intraluminal mass (82% vs 43%, p <0.001), culprit lesion multiple plaque ruptures (23% vs 6%, p <0.001), and tissue prolapse (51% vs 35%, p = 0.043) were observed more frequently in patients with no reflow. In multivariate logistic regression analysis, an intraluminal mass (odds ratio [OR] 4.84, 95% confidence interval [CI] 1.98 to 10.49, p = 0.001), culprit lesion multiple plaque ruptures (OR 3.46, 95% CI 1.46 to 8.41, p = 0.014), and degenerated SVGs (OR 3.17, 95% CI 1.17 to 6.56, p = 0.024) were the independent predictors of no reflow after PCI. At 5-year clinical follow-up, rates of death (14, 36%, vs 55, 20%, p = 0.036) and myocardial infarction (13, 33%, vs 52, 19%, p = 0.039) were significantly higher in the no-reflow group. However, rate of target vessel revascularization was not significantly different between the 2 groups (15, 38%, vs 90, 33%, p = 0.3). IVUS-detected intraluminal mass, multiple plaque ruptures, and degenerated SVGs were associated with no reflow in SVG lesions after PCI. In conclusion, no reflow was associated with poor long-term clinical outcomes after PCI for SVG lesions. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;109:1576-1581)
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > College of Medicine > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.